The purpose of the project is to develop an advanced Vestibular Evoked Myogenic Potential (VEMP) screening and testing device. VEMP testing has been recognized as an indirect measure of the functional integrity of the saccule, a portion of the otoliths, the inferior vestibular nerve or other central connections of the saccule. VEMPs are currently acquired using standard Auditory Evoked Potential (AEP) systems which do not provide adequate controls over background EMG activity required to record consistent and valid VEMP responses. The proposed system will be made available either as a VEMP specific module within SmartEP, an AEP system manufactured by Intelligent Hearing Systems, integrating hearing and vestibular assessment, or as a compact portable VEMP device to be used for vestibular screening, testing, ototoxicity monitoring and other related applications. During Phase I, a VEMP module incorporating background EMG monitoring and patient feedback with video display reinforcement for testing children was developed and tested. Chained-Stimuli and CLAD high stimulation rate testing techniques were also successfully applied to VEMP testing. Acquisition and data analysis parameters were also optimized. During Phase II, a comprehensive clinical trial will be conducted to obtain normative data from 300 subjects. A computer controlled skull tap stimulator and bone vibrator headband will also be developed to facilitate VEMP testing using these techniques. The proposed device will have a direct impact on public health by standardizing the acquisition of VEMP responses, which provide a unique and objective test of saccule function, in an integrated testing module. VEMP testing has emerged as an important and valid procedure that detects the functional integrity of the saccule and the inferior vestibular nerve. The use of the proposed VEMP system is expected to greatly improve the clinical utility and data quality of VEMP testing. As such, the proposed work will greatly impact public health by developing better VEMP testing systems.